Recent advances in clinical practice challenges and opportunities in the management of obesity

Gut. 2014 Apr;63(4):687-95. doi: 10.1136/gutjnl-2013-306235. Epub 2014 Jan 8.

Abstract

Despite advances in understanding the roles of adiposity, food intake, GI and adipocyte-related hormones, inflammatory mediators, the gut-brain axis and the hypothalamic nervous system in the pathophysiology of obesity, the effects of different therapeutic interventions on those pathophysiological mechanisms are controversial. There are still no low-cost, safe, effective treatments for obesity and its complications. Currently, bariatric surgical approaches targeting the GI tract are more effective than non-surgical approaches in inducing weight reduction and resolving obesity-related comorbidities. However, current guidelines emphasise non-surgical approaches through lifestyle modification and medications to achieve slow weight loss, which is not usually sustained and may be associated with medication-related side effects. This review analyses current central, peripheral or hormonal targets to treat obesity and addresses challenges and opportunities to develop novel approaches for obesity.

Keywords: BRAIN/GUT INTERACTION; GASTROINTESTINAL HORMONES; OBESITY.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Bariatric Surgery / methods
  • Central Nervous System / physiopathology
  • Humans
  • Incretins / physiology
  • Microbiota / physiology
  • Obesity / drug therapy
  • Obesity / physiopathology
  • Obesity / surgery
  • Obesity / therapy*
  • Weight Reduction Programs

Substances

  • Incretins